Aging with multiple sclerosis and associated prevalence, incidence, comorbidities and healthcare utilization patterns in a population based study.

In multiple sclerosis (MS), traditionally considered a disease of predominantly young adults, the growing proportion of aging patients has created an uncharted patient population, whose healthcare needs have not been thoroughly investigated. In this population-based study using the database of the major healthcare organization in Israel, we report the prevalence and incidence of older people with (PwMS), and of people with Rheumatoid Arthritis (PwRA) for comparison, between 2003 and 2022. The increase in MS prevalence in Israel was most pronounced in age group ≥ 60 years, rising from 4.6 to 18.2 per 10,000 people, with the steepest increase observed among older Jewish women. This resulted in an increase in the mean patient age, with PwMS aged ≥ 60 years accounting for 31% of the patients in 2022. Among PwRA aged ≥ 60 years, the steepest increase in RA prevalence was noticed in Arab women. The annual incidence of MS or RA in older patients remained stable during this period. Several comorbidities, including psychiatric and neurodegenerative disorders, stroke and osteoporosis, were more frequent among older PwMS and PwRA, and these patients utilized more healthcare services, including multi-hospitalizations and visits to specialists, than an age- and gender-matched general population. Our study highlighted the phenomenon of growing prevalence of aging PwMS, with gender and ethnicity-specific patterns, emphasizing both the complex medical needs of this aged patient population and the burden of this chronic neurological disease in later life on patients' quality of life as well as on healthcare systems.